Sandra Leal, PharmD, MPH, CDE serves as Vice President for Innovation at SinfoníaRx in Tucson, Arizona. She is currently the Board Chair for the National Center for Farmworker health.
I have always had a special place in my heart for agricultural workers. One of my father’s first jobs when he came to the United States from Mexico was working the fields in California picking lettuce. When I was young, and later in life, my father would recall the hard work he had to endure in order to provide for his family. He would tell me about the long days, the back pain, waking up very early in the mornings and having to work late into the day and at night irrigating the fields. In trying to recall how long my father did this work, I called my mother to ask her if she could give me more detailed information, since my dad passed away in 2008. She remembers him working for over five years as an Ag worker. He was in his mid 20’s at the time and they were new parents to my older brother. She reminisced about those times fondly because it was that work that allowed for them to reunite, as she had stayed in Mexico until he was able to find them a home in the United States.
I was honored to work on a project that NCFH launched in 2008 to improve prescribing in health centers. It was incredible to assist the population my father once belonged to, especially because his efforts provided me the vehicle to be able to go to college to become a pharmacist. As a pharmacist working on this project, I immediately saw a tremendous need to decrease fragmentation of care, especially for populations that migrate. I was especially taken aback by the number of chronic conditions that Ag workers faced and the challenge of being able to take care of these conditions with issues like low health literacy, access to care, and lack of health insurance.
I decided very early on in my career to work with underserved and underinsured populations because I felt that I could positively impact those populations the most. I grew up in a Spanish speaking household and realized how difficult it was to ask questions of health care providers that did not speak the same language. I specifically decided to become a pharmacist since pharmacists are some of the most accessible providers and I could help advocate for people that came to see me. Over the years I ended up becoming a certified diabetes educator to target the disproportionate amount of diabetes in my community. I developed team-based care clinic at El Rio Community Health Center to improve health outcomes, access and affordability for people with diabetes and other chronic conditions. During my time there, I ended up obtaining a degree in public health since it became apparent that we needed to work on population health and policy to address issues on a large scale.
Today, I continue to work on many of the same issues that still exist. I have been blessed to serve on the board of NCFH to continue to support agricultural worker health. My experience on the board has exposed me to some of the most caring individuals that continuously work to improve access to quality care for the Ag worker population that works so hard for us. I truly believe that if enough of us care for this population and take action, we will eventually eliminate structural and cultural barriers to provide equitable access that eliminates unjust and unequal treatment.